韦氏颈椎手法配合中药烫疗治疗神经根型颈椎病的临床研究

Clinical study on the curative effect of Wei's cervical vertebra adjusting manipulation combined with hot compress with traditional Chinese drug in the treatment of cervical spondylotic radiculopathy

目的:观察韦氏颈椎手法配合中药烫疗治疗神经根型颈椎病的临床疗效。方法:将264例神经根型颈椎病患者随机分为治疗组133例和对照组131例。治疗组采用韦氏颈椎手法配合中药烫疗治疗,对照组采用颈椎牵引配合中药烫疗治疗。治疗结束后3个月分别采用Boeden测量法、Northwick Park颈痛量表及《中医病证诊断疗效标准》中的颈椎病疗效标准评定并比较2组患者的颈椎生理曲度、颈椎症状体征功能评分及总体疗效。结果:①颈椎生理曲度。治疗前2组患者颈椎生理曲度比较,差异无统计学意义[(3.67±2.32)mm,(3.15±2.14)mm,t=-1.194,P=0.234];治疗结束后3个月2组患者颈椎生理曲度均改善[(7.79±3.74)mm,(5.98±3.56)mm],治疗组改善更明显[(4.12±2.34)mm,(2.83±1.18)mm,t=5.221,P=0.000]。②颈椎症状体征功能评分。治疗前2组患者颈椎症状体征功能评分比较,差异无统计学意义[(38.77±12.25)分,(38.36±8.79)分,t=0.311,P=0.756];治疗结束后3个月2组患者的颈椎症状体征功能评分均降低[(17.65±5.94)分,(20.50±8.79)分],治疗组降低更明显[(21.12±10.64)分,(17.86±8.93)分,t=2.310,P=0.022]。③总体疗效。治疗组治愈32例,显效81例,有效15例,未愈5例;对照组治愈12例,显效85例,有效17例,未愈17例。治疗组总体疗效优于对照组,差异有统计学意义(Z=-3.569,P=0.000)。结论:采用韦氏颈椎手法配合中药烫疗治疗神经根型颈椎病,能有效改善患者的临床症状与体征,以及颈椎生理曲度和颈椎功能,疗效优于颈椎牵引配合中药烫疗,值得临床推广应用。

Objective：To observe the clinical curative effect of Wei＇s cervical vertebra adjusting manipulation combined with hot compress with traditional Chinese drug（TCD） on cervical spondylotic radiculopathy.Methods：Two hundred and sixty-four patients with cervical spondylotic radiculopathy were randomly divided into 2 groups,133 cases in the treatment group were treated with Wei＇s cervical vertebra adjusting manipulation combined with hot compress with TCD,while the others in the control group were treated with cervical traction combined with hot compress with TCD.The cervical vertebra physiological curvature,sign＆symptoms and performance score and total curative effect were evaluated and compared between the 2 groups at 3 months after the end of the treatment by respectively using Boeden measurement,Northwick Park Neck Pain Questionnaire and therapeutic effects evaluation standard of cervical spondylosis which was extracted from Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes.Results：There was no statistical difference in the cervical vertebra physiological curvature between the 2 groups before the treatment（3.67 ＋/-2.32 vs 3.15 ＋/-2.14 mm,t =-1.194,P =0.234）,while the cervical vertebra physiological curvature improved in both of the 2 groups at 3 months after the end of the treatment（7.79 ＋/-3.74 vs 5.98 ＋/-3.56 mm）and there was a bigger improvement in the treatment group （4.12 ＋/-2.34 vs 2.83 ＋/-1.18 mm,t =5.221,P =0.000）.There was no statistical difference in the sign＆symptoms and performance score of cervical vertebra between the 2 groups before the treatment （38.77 ＋/-12.25 vs 38.36 ＋/-8.79 points,t =0.311,P =0.756）,while the scores declined in both of the 2 groups at 3 months after the end of the treatment（17.65 ＋/-5.94 vs 20.50 ＋/-8.79 points） and there was a bigger decline in the treatment group（21.12 ＋/-10.64 vs 17.86 ＋/-8.93 points,t =2.310,P =0.022）.Thirty-two patients were cured,81 good,15 fair and 5 poor in the treatment group; while 12 patients were cured,85 good,17 fair and 17 poor in the control group.The treatment group surpassed the control group in the total curative effect and there was statistical difference between the 2 groups （Z =-3.569,P =0.000）.Conclusion：For patients with cervical spondylotic radiculopathy,the therapy of Wei~ cervical vertebra adjusting manipulation combined with hot compress with TCD can effectively improve the clinical symptoms and signs,cervical vertebra physiological curvature and performance of cervical vertebra,and its curative effect is better than that of cervical traction combined with hot compress with TCD,so it is worthy of popularizing in clinic.